Is there a role for fetal interventions in gastroschisis management? – An updated comprehensive review

We conducted a comprehensive evidence-based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a periumbilical abdominal wall defect characterized by abdominal viscera herniation in utero. It affects 4 in 10 000 live births, but the prevalence has steadily increased in recent years. Gastroschisis is typically diagnosed on routine second-trimester ultrasound. The overall prognosis is favorable, but complex gastroschisis, which accounts for about 10% to 15% of cases, is associated with a higher mortality, significant disease burden and higher healthcare costs due to long- and short-term complications. The current standard of care has yet to be established but generally involves continued fetal surveillance and multidisciplinary perinatal care. Postnatal surgical repair is achieved with primary closure, staged silo closure or sutureless repair. Experimental animal studies have demonstrated the feasibility of in utero closure, antiinflammatory therapy and prenatal regenerative therapy. However, reports of early preterm delivery and amnioinfusion trials have failed to show any benefit in humans. Further experimental studies and human trials are necessary to demonstrate the potential benefit of fetal therapy in gastroschisis.     

Sustainability: A Study of the Level of Ecological Behavior of Postgraduate Students in Brazil

The decline in the supply of natural resources is a cause for concern, especially given continued worldwide population growth. New habits and attitudes toward resource use are slowly being introduced into the everyday lives of persons residing in a number of countries. The term “ecological behavior” refers to acting in favor of the environment, whether these actions are voluntarily or not, or learned or not (Pato & Tamayo, 2006 ). The general objective of this study is to identify the environmental behavior—one of several terms used interchangeably with ecological behavior—of graduate students from a Brazilian federal institution of higher education. We chose this particular group because many of them already act, or will act, as professors. Thus, by virtue of their positions, they will function as opinion leaders who will influence the education of future professionals, establishing a chain through which shared values can gradually change the environmental behavior of society.     

Assessment of Eutrophication in Estuaries: Pressure–State–Response and Nitrogen Source Apportionment

A eutrophication assessment method was developed as part of the National Estuarine Eutrophication Assessment (NEEA) Program. The program is designed to improve monitoring and assessment of eutrophication in the estuaries and coastal bays of the United States with the intent to guide management plans and develop analytical and research models and tools for managers. These tools will help guide and improve management success for estuaries and coastal resources. The assessment method, a Pressure-State-Response approach, uses a simple model to determine Pressure and statistical criteria for indicator variables (where applicable) to determine State. The Response determination is mostly heuristic, although research models are being developed to improve that component. The three components are determined individually and then combined into a single rating. Application to several systems in the European Union (E.U.), specifically in Portugal, shows that the method is transferable, and thus is useful for development of management measures in both the Unites States and E.U. This approach identifies and quantifies the key anthropogenic nutrient input sources to estuaries so that management measures can target inputs for maximum effect. Because nitrogen is often the limiting nutrient in estuarine systems, examples of source identification and quantification for nitrogen have been developed for 11 coastal watersheds on the U.S. east coast using the WATERSN model. In general, estuaries in the Northeastern United States receive most of their nitrogen from human sewage, followed by atmospheric deposition. This is in contrast to some watersheds in the Mid-Atlantic (Chesapeake Bay) and South Atlantic (Pamlico Sound), which receive most of their nitrogen from agricultural runoff. Source identification is important for implementing effective management measures that should be monitored for success using assessment methods, as described herein. For instance, these results suggest that Northeastern estuaries would likely benefit most from improved sewage treatment, where as the Mid and South Atlantic systems would benefit most from agricultural runoff reductions.     

Curcumin and Its Analogs as a Therapeutic Strategy in Infections Caused by RNA Genome Viruses

Food and Environmental Virology - The use of natural resources for the prevention and treatment of diseases considered fatal to humanity has evolved. Several medicinal plants have nutritional and...     

Applications of life cycle assessment and cost analysis in health care waste management

The establishment of rules to manage Health Care Waste (HCW) is a challenge for the public sector. Regulatory agencies must ensure the safety of waste management alternatives for two very different profiles of generators: (1) hospitals, which concentrate the production of HCW and (2) small establishments, such as clinics, pharmacies and other sources, that generate dispersed quantities of HCW and are scattered throughout the city. To assist in developing sector regulations for the small generators, we evaluated three management scenarios using decision-making tools. They consisted of a disinfection technique (microwave, autoclave and lime) followed by landfilling, where transportation was also included. The microwave, autoclave and lime techniques were tested at the laboratory to establish the operating parameters to ensure their efficiency in disinfection. Using a life cycle assessment (LCA) and cost analysis, the decision-making tools aimed to determine the technique with the best environmental performance. This consisted of evaluating the eco-efficiency of each scenario. Based on the life cycle assessment, microwaving had the lowest environmental impact (12.64 Pt) followed by autoclaving (48.46 Pt). The cost analyses indicated values of US$ 0.12 kg^?1 for the waste treated with microwaves, US$ 1.10 kg^?1 for the waste treated by the autoclave and US$ 1.53 kg^?1 for the waste treated with lime. The microwave disinfection presented the best eco-efficiency performance among those studied and provided a feasible alternative to subsidize the formulation of the policy for small generators of HCW.